Novel Non-Invasive Measurement of Carpal Tunnel Pressure

 描述（由申请人提供）：腕管综合征（CTS）是最常见的神经病;它影响数百万人，特别是工人阶级，并造成巨大的经济负担。腕管压力增加被认为是CTS的主要原因。腕管压力升高直接损伤滑膜下结缔组织并诱导缺血再灌注损伤，这导致结缔组织纤维化，这是CTS中最常见的病理发现。腕管压力在临床上被公认为是评估CTS的阶段或严重程度以及治疗有效性的关键生物标志物和敏感指标。然而，目前用于测量腕管压力的技术是侵入性的和痛苦的;因此，它不是临床上常规使用的。相反，肌电图被用来检测正中神经的变化，通常发生在后期CTS，当正中神经功能受损。因此，开发一种非侵入性的方法来测量腕管压力是至关重要的评估CTS。本申请的总体目标是开发新技术，以通过利用在高压下剪切波沿肌腱沿着的传播速度被改变并且可以通过超声弹性成像检测的事实来非侵入性地测量腕管压力。我们从一个简化模型的初步数据已经证明了一个高的可能性，在手腕肌腱可以作为传感器，传感腕管压力。在完成我们提出的目标后，我们将开发出一种新颖，独特和非侵入性的工具，可用于定义腕管压力在CTS起源，进展因素，早期诊断，治疗选择和结果方面的作用。

 DESCRIPTION (provided by applicant): Carpal tunnel syndrome (CTS) is the most common neuropathy; it affects millions, especially in the working- class population, and causes a huge economic burden. Increased carpal tunnel pressure is considered a major cause of CTS. Elevated carpal tunnel pressure directly damages subsynovial connective tissue and induces ischemia reperfusion injury, which leads to connective tissue fibrosis, the most common pathologic finding in CTS. Carpal tunnel pressure is clinically well recognized as a key biomarker and sensitive indicator for assessing stage or severity of CTS and the effectiveness of treatment. However, the current technique for measuring carpal tunnel pressure is invasive and painful; it therefore is not routinely used clinically. Instead, electromyography is used to detect median nerve changes that generally occur during late-stage CTS, when median nerve function is impaired. Therefore, development of a noninvasive method to measure carpal tunnel pressure is critical for evaluating CTS. The overall goal of the current application is to develop novel technology to noninvasively measure carpal tunnel pressure by exploiting the fact that under high pressure, shear wave propagation velocity along a tendon is altered and can be detected by ultrasound elastography. Our preliminary data from a simplified model has demonstrated a high likelihood that a tendon in the wrist can serve as a transducer that senses carpal tunnel pressure. After completion of our proposed aims, we will have developed a novel, unique and noninvasive tool that can be used to define the role of carpal tunnel pressure with regard to CTS origin, progressive factors, early diagnosis, treatment options, and outcome.